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Does the Modified Mallampati Scoring Method Effectively Screen for Obstructive Sleep Apnea (OSA)? Isadore Tarantino 1, Tim Quinn 1, Larry Dall 1, Nurry.

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Presentation on theme: "Does the Modified Mallampati Scoring Method Effectively Screen for Obstructive Sleep Apnea (OSA)? Isadore Tarantino 1, Tim Quinn 1, Larry Dall 1, Nurry."— Presentation transcript:

1 Does the Modified Mallampati Scoring Method Effectively Screen for Obstructive Sleep Apnea (OSA)? Isadore Tarantino 1, Tim Quinn 1, Larry Dall 1, Nurry Pirani 1,2 1 UMKC School of Medicine, 2 Truman Medical Center INTRODUCTION People with OSA often have positive screening measures such as snoring, daytime fatigue, observed cessation of breathing during sleep, hypertension, high BMI, advanced age, thick neck circumference, and male gender; measurements annotated on the STOP-BANG questionnaire (SBQ) [1]. Mallampati scores, which are assessed by the degree of oropharyngeal patency, are overlooked and underrepresented even with the current literature reporting a positive correlation between the severity of a Mallampati score and worsening OSA [2]. This led us to investigate if Mallampati scores could stand alone as a strong predictive screening measure for OSA. METHODS Data collection Complete a physical Mallampati assessment. Complete a SBQ. Undergo a polysomnogram (PSG) if: Subject has a Mallampati Class II-IV, or Subject has a Mallampati class I and >2 positives SBQ Data Analysis Paired T-test was analyzed on the subject’s Mallampati score with each criteria of the SBQ, apnea-hypopnea index (AHI), and insurance type. CONCLUSION OSA is estimated to be as high as 7% in the United States [4]. This may be an underestimation due to the impact of excluding a subpopulation of people who may not meet criteria of the STOP-BANG questionnaire but have a significant Mallampati score. The clinical health implications for undiagnosed chronic OSA are staggering; including arterial HTN, pulmonary HTN, CAD, CHF, arrhythmia, and obesity [5]. It is imperative to create a more thorough and objective screening assessment for patients at risk of having undiagnosed OSA to prevent future health comorbidities and early death. Significant correlation between Mallampati score and neck circumference was found which may relate to the degree of subcutaneous fat tissue as an underlying etiology. Possible trend between Mallampati score and AHI score; however additional subjects are needed to adequately evaluate whether a statistical significance exists. REFERENCES 1)Frances Chung, F.R.C.P.C.: A Tool to Screen Patients for Obstructive Sleep Apnea. Anesthesiology, 2008; 108:812–21. 2)Rodrigues MM.: Nasal obstruction and high Mallampati score as risk factors for Obstructive Sleep Apnea. Braz J Otorhinolaryngol, 2010; 76(5): )Samsoon GL.: Difficult tracheal intubation: a retrospective study. Anastasia, 1987; 42:487. 4)Naresh M. Punjabi: The Epidemiology of Adult Obstructive Sleep Apnea. Proc Am Thorac Soc, 2008; 5(2): 136–143. 5)Abdullah B.: Obstructive Sleep Apnea Syndrome and its Comorbid Medical Conditions. Otolaryngol, 2012; 2:e103. OBJECTIVES The objective of this study is to assess how credible a Mallampati score can be as an independent screening measure for OSA. The aim of the study is to improve patient care by creating a more thorough screening measure for OSA with the incorporation of using a Mallampati score in addition to the traditional SBQ. Contributors: 1) UMKC School of Medicine Kansas City, MO, USA. 2) Truman Medical Center Kansas City, MO, USA. 3) The UMKC medical students of unit Green 4. DIAGRAM Figure 1 [3] RESULTS 32 subjects total Significant correlation found between Mallampati score and neck circumference. No significant correlation found between Mallampati score and the remaining SBQ criteria or insurance coverage. Subject #Mallampati scoreSTOPBANG scoreAHI score Subject 14/45/856 Subject 23/47/836 Subject 33/43/82 3/32 subjects have completed a PSG No significant correlation found between Mallampati score and AHI. No significant correlation found between SBQ and AHI. Possible trend between Mallampati score and AHI score. Paired-T test CICorrelationP-Value Mallampati Score: Height95% Mallampati Score: Weight95% Mallampati Score: BMI95% Mallampati Score: Age95% Mallampati Score: Gender95% Mallampati Score: Neck Circumference95% Mallampati Score: Snoring95% Mallampati Score: Daytime Fatigue95% Mallampati Score: Stop Breathing95% Mallampati Score: Hypertension95% Mallampati Score: STOPBANG95% Mallampati Score: TMC-Discount95% Mallampati Score: Medicare Insurance95% Mallampati Score: Medicaid Insurance95% Mallampati Score: Private Insurance95% Subjects CICorrelationP-Value Mallampati Score: AHI95% STOPBANG Questionnaire: AHI95% Details on the 3 subjects


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